10D2231615 CLIA NUMBER - MIRACLE COMMUNITY BEHAVIORAL CENTER CORP

Laboratory Demographics

  • CLIA Code: 10D2231615
  • Facility Name: MIRACLE COMMUNITY BEHAVIORAL CENTER CORP
  • Facility Address: 15660 SW 72 ST
    MIAMI, FL
    ZIP 33193
  • Facility Phone: 786 697-1150
  • Facility Type: Other - MEDICAL CENTER
  • Facility Type: Waiver
  • Lab Director: BRISAIDA DUARTE
  • NPI Number: 1700491552
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2231615
LAB Type Other - MEDICAL CENTER
Facility Name MIRACLE COMMUNITY BEHAVIORAL CENTER CORP
Street 15660 SW 72 ST
City MIAMI
State FL
ZIP 33193
Phone 786 697-1150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Other - MEDICAL CENTER
Lab Director BRISAIDA DUARTE

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This page was last updated on: 9/29/2025